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患者,男,31岁,住院号145741。主诉不规则发热伴胸闷、气急、心悸半年。半年前,患者突然畏寒发热,体温39℃,血白细胞21,000/立方毫米。即用青、链霉素和土霉素治疗达一个月,高热未退。曾住院检查,发现有先天性心脏病和亚急性细菌性心内膜炎(SBE)体征,但血培养细菌多次阴性。住院期间曾用青、链霉素和红霉素、卡那霉素、罗旋霉素等均无明显效果。有时体温也可下降,甚至正常数日,但不久又上升,体温波动在37～40℃之间,停用抗菌素病情也未见恶化。1979年9月14日转入中山医院,从病史查问出患者在发热前一个多月曾拔去蛀牙一颗。入院当天连续三次取血样作厌氧菌培养,均为微需氧性微小消化链球菌。根据药敏试验结果,用四环素和氯霉素治疗,患者体温开始下降。后因患者对四环素过敏,改用氯霉素加大量的青霉素(1,080万单位/日)静脉滴注,体温降到正常。以后在11月16和23日又连续6次做厌氧血培养,均为阴性。病人共住院观察3个多月,不再发热,于12月中旬病愈出院。
Patient, male, 31 years old, hospital number 145741. Irregular fever complaints with chest tightness, shortness of breath, palpitations six months. Six months ago, the patient suddenly chills and fever, body temperature 39 ℃, blood leukocytes 21,000 / cubic millimeter. That is, blue, streptomycin and oxytetracycline treatment for a month, high fever did not back. Had hospitalized and found congenital heart disease and subacute bacterial endocarditis (SBE) signs, but blood culture bacteria repeatedly negative. During hospitalization with blue, streptomycin and erythromycin, kanamycin, rotenamicin, etc. no significant effect. Sometimes body temperature can also drop, or even a few days, but soon rose, body temperature fluctuations between 37 ~ 40 ℃, the disabled antibiotics have not deteriorated. September 14, 1979 transferred to Zhongshan Hospital, check the history from patients with fever in more than a month had pulled a tooth decay. On the day of admission, three consecutive blood samples were taken for anaerobic culture, all of which were micro-aerobic micro-digestive streptococci. According to susceptibility testing results, with tetracycline and chloramphenicol treatment, patients began to decline in body temperature. After the patient due to tetracycline allergy, switch to chloramphenicol plus a large amount of penicillin (10.8 million units / day) intravenous infusion, the body temperature dropped to normal. Later in November 16th and 23rd again in 6 consecutive anaerobic blood culture, were negative. Patients were hospitalized for more than 3 months observation, no longer fever, discharged in mid-December.